Ask Dr. Laura Berman

Can Blood Pressure Meds Affect Erections?

Q: I am 55 years old, and my blood pressure has stabilized because I take 40 mg of nadolol daily. However, I find that it's not as easy to have erections anymore. I read that blood pressure medications can cause this problem. Is this true? Is it safe to take Viagra?
— Warren, Mississippi

Blood pressure medications work by relaxing the body's blood vessels and making them open wider, which in turn lowers the pressure inside them. While this is good for the heart (because it doesn't have to work as hard to pump blood throughout the body), these meds often interfere with sexual function. There are eight categories of blood pressure medications — each type works differently to lower blood pressure — and some of them reduce the pressure so much that there's not enough blood available to the penis for a successful erection. Unfortunately, nadolol is in the beta-blocker family of blood pressure medications, which, along with diuretics, have been found to have the highest incidence of sexual side effects.

The good news is that there are hundreds of blood pressure meds on the market, many of which seem to have fewer sexual side effects. In particular, calcium channel blockers, angiotensin receptor blockers, and ACE inhibitors may have less effect on sexual function. Only your physician can determine whether it's appropriate for you to switch your meds based on your particular health history, but it's worth having the conversation.

In the meantime, you may be able to take advantage of Viagra because nadolol does not contain nitrites. (The combination of Viagra and nitrites can cause a fatal drop in blood pressure.) Again, only your physician can determine whether this is the right move for you, but many men on blood pressure medications do take Viagra and other erectile dysfunction (ED) drugs. If Viagra isn't an option, you may want to try a vacuum device or the injected medication alprostadil. Both help draw blood into the penis to create a lasting erection without the side effects.

Last Updated: 04/02/2007

Laura Berman, PhD, is a leading sex and relationship educator and therapist, popular TV and radio host, New York Times best-selling author, and assistant clinical professor of ob-gyn and psychiatry at the Feinberg School of Medicine at Northwestern University in Chicago.

Thanks to: http://www.everydayhealth.com/sexual-health/sex-and-aging/specialist/berman/blood-pressure-meds-and-erections.aspx?xid=nl_EverydayHealthSexualHealth_20130412